Colonial Roots of the Opioid Crisis

Indigenous people in the province of Alberta descend from peoples for whom traditional organization and knowledge systems have been persistently attacked by colonial forces. Throughout the 1700s and 1800s, repeated waves of infectious disease killed high rates of communities, sometimes wiping out whole camps. As a precursor to contemporary struggles with substance misuse among some, the late nineteenth-century saw whiskey traders follow camps around to trade buffalo hides for a concoction more toxic than alcohol. Today, community knowledge holders and leaders identify current struggles with addiction among some of their members as the result of historical rupture and ongoing trauma. The overdose crisis is therefore experienced as an enduring legacy of colonization. 

The Overdose Crisis and Indigenous People Today

In Alberta, opioid dispensation (1) (2)opioid-related emergency department visits and associated hospitalizations (3) are significantly higher for First Nations (FN) patients than for the non-First Nations population. A report published by the Alberta First Nations Information Governance Centre (AFNIGC) and the Alberta Government indicates that rates of apparent accidental opioid drug toxicity deaths among FN people throughout 2016 were three times higher than among non-FN people. While limited data exists for other Indigenous groups across Canada, a narrative review of available data indicates that dispensing, use, and misuse of prescription opioids are high and/or rising among Indigenous populations, suggesting that patterns in Alberta are aligned with trends elsewhere.


Understanding a burden of opioid misuse among FNs is complicated by the task of identifying not only physiological, but also social, material, and political pathways to such health inequities. The task is further complicated by the challenge of not perpetuating a deficit lens (i.e., victim-blaming, moralization) when identifying disparities and drivers of adverse outcomes among under-served and racialized populations.

What are our objectives? 

1. Contextualize systemic drivers of opioid misuse in Indigenous contexts in Alberta

2. Profile the diversity of Indigenous and health community responses to the opioid/overdose crisis 

3. Detail Indigenous community priorities and strategies for healing from substance misuse

Multiple Research Initiatives

Knowledge Synthesis 


Best Practices and Contextual Factors Enhancing Prevention and Treatment of Opioid Misuse in Indigenous Contexts in Alberta 

Opioid Prescribing


Understanding Structural Drivers of Prescription Drug Misuse to Address Medicine's Role in the Opioid Crisis affecting First Nations people in Alberta

Opioid Agonist Therapy in Primary Care
Enhancing Primary Care Capacity for Opioid Agonist Therapy in Indigenous Contexts in Alberta (COATICA)
Opioid Crisis Response Evaluation


Evaluate one First Nation's crisis response through culturally congruent process of story telling, information synthesis & sharing of knowledge for community healing